Retroperitoneal GIST: An exceptional location of a rare tumour. A case report from Ouagadougou and review of the literature. (December 2021)

• Record Type: Journal Article
• Authors: Zongo, Nayi; Ouédraogo, Nabonswindé Lamoussa Marie; Koama, Adjirata; Windsouri, Mamadou; Ouattara, Souleymane; Yameogo, Paratyande Bonaventure
• Is Part Of: International journal of surgery case reports. Volume 89(2021)
• Publication Date: 2021-12
• Subjects: Gastro-Intestinal-Stromal-Tumour -- Retroperitoneum -- Surgery -- Imatinib -- Case report -- Ouagadougou; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2021.106613
• Languages: English
• ISSNs: 2210-2612

Abstract

Abstract: Introduction: GIST can occur in all segments of the gastrointestinal tract with a predilection for the stomach. Retroperitoneal localization remains exceptional. We report a case to describe our diagnostic and therapeutic approach. Case presentation: A 55-year-old patient was admitted with borborygms and a sensation of lumbar swelling for 6 months. He was diabetic and hypertensive. The clinical examination noted a right lumbar mass with perception of bowel sound anterior to the mass, with minimal discomfort and mobility. Ultrasound revealed a hypervascularised, encapsulated, well-limited retroperitoneal tissue mass in contact with the right psoas muscle. Abdomino-pelvic CT scan showed a large, hypervascularized, encapsulated, calcified tissue mass measuring 147 × 106 mm in close contact with the outer edge of the right psoas muscle, suspected of being malignant. MRI noted a suspicious process developed at the expense of the right psoas muscle in its lumbar and iliac portion suggestive of a psoas rhabdomyosarcoma. The patient underwent laparotomy with a retroperitoneal approach by lumbar incision. Histology and immunohistochemistry revealed a GIST expressing CD117. The patient was put on imatinib for 6 months. He is complaint-free after 4 months. Discussion: Despite the rarity of retroperitoneal GIST, it should be considered in the presence of any retroperitoneal mass. This will allow for early management. Conclusion: Retroperitoneum is an exceptional location for GIST. Surgery remains the mainstay of curative treatment. Adjuvant imatinib reduces the risk of recurrence. The prognosis is usually good. Highlights: We report a case of retroperitoneal gastroinstestinal stroma tumor (GIST)GIST: an exceptional location of a rare tumor in a 55-year-old patient from Ouagadougou. The symptoms have evolved about six months. The clinical examination noted a right lumbar mass with perception of bowel sound anterior to the mass. Histology and immunohistochemistry revealed a GIST expressing CD117 The patient underwent laparotomy with a right lumbar incision on top of the swelling with uneventful postoperative course.